Surgical clip and surgical method for treating an aneurysm

Abstract

The present invention relates to a surgical clip comprising a first arm and a second arm, the first and second arms having first and second clamping surfaces facing each other, and the first and second arms being mounted for movement relative to each other, and further comprising a distance retaining device for keeping the first and second arms permanently spaced from each other.The present invention also relates to a surgical method for treating an aneurysm, the method comprising: applying a surgical clip to the aneurysm, the clip comprising a first arm and a second arm, aid first and second arms having first and second clamping surfaces facing each other for clamping the aneurysm therebetween, the first and second arms being mounted for movement relative to each other, and the first and second arms being kept permanently spaced from each other, wherein the aneurysm is clamped between the arms kept permanently spaced from each other.

Description

FIELD OF THE INVENTION[0001]The present invention relates in general to a surgical clip and, more specifically, to a surgical clip comprising a first arm and a second arm, the first and second arms having first and second clamping surfaces facing each other, and the first and second arms being mounted for movement relative to each other.[0002]The present invention also relates, in general, to a surgical method for treating an aneurysm and, more specifically, to a surgical method for treating an aneurysm, the method comprising: applying a surgical clip to the aneurysm, the clip comprising a first arm and a second arm, the first and second arms having first and second clamping surfaces facing each other for clamping the aneurysm therebetween, and the first and second arms being mounted for movement relative to each other.BACKGROUND OF THE INVENTION[0003]Aneurysms are abnormal dilatations of blood vessels. A critical type of aneurysm is a brain aneurysm which is an abnormal dilatation ...

AI Technical Summary

Problems solved by technology

Over time, the natural pulsation of blood against the area of weakness can gradually cause the weakened area to dilate or enlarge.

Eventually, if the wall is stretched too thin, the balloon bursts.

Unfortunately, despite best medical efforts, SAH will be fatal in roughly 50% of the cases, with a significant percentage of patients dying before they even reach the hospital.

Of survivors, approximately one half are left with permanent disability, for example, a stroke, which permanently compromises their independence and quality of life.

These non-invasive techniques allow for the demonstration of an aneurysm before it bleeds, and their increasing use has led to the discovery of an unexpectedly significant number of patients with unruptured, asymptomatic lesions.

Unfortunately, coiling works best for aneurysms with a narrow neck that will help prevent the coil mass from herniating back into the main artery, i.e. the parent artery.

In wider necked aneurysms, such coil protruding into the main artery could result in blockage of blood supply through the main artery and subsequent stroke.

In addition, many aneurysms will recur or regrow after coiling.

As the blood pumps against the coil mass sitting in the aneurysm, it tends to “compact” the coils themselves out towards the dome of the aneurysm, and then blood flow can once again enter the aneurysm, and the patient is again at risk for bleeding from the thin wall of the aneurysm.

An aneurysm may not allow a clip to close properly because there is atheroma or calcium, which form a hardening of the artery within the wall of the aneurysm itself, because there is organized hematoma or thrombus within the aneurysm itself, or because the aneurysm is filled with coils from a previous endovascular treatment.

When traditional clips fail because of non-compliance of the aneurysm, a dangerous situation is created.

The clip can slip back off the aneurysm, it can be forced down onto the neck of the aneurysm blocking flow through the main artery or its branches, or it can tear through the wall of the aneurysm with disastrous consequences.

The large and giant aneurysms are the ones most likely to have thick non-compliant walls, and these aneurysms represent a serious management challenge.

Also, the growing number of previously coiled aneurysms that have failed and recurred is increasing exponentially.

There are no optimal treatments for these lesions today.

The aneurysms can be “crushed” with a forceps or clamp first to allow the clips to close, but this is a dangerous maneuver that can rupture the aneurysm or shower clot out of the aneurysm into the blood supply causing a stroke.

Unfortunately, stopping the blood flow to the aneurysm, even temporarily, may mean stopping the blood flow to the normal brain which can cause a stroke.

Even if no stroke occurs from the temporary arterial occlusion, the wall of the aneurysm may be brittle or friable and may not be repairable once opened resulting in disaster.

If the bypass is unsuccessful, the result is usually a severe stroke.

Some aneurysms can be re-filled with coils, but many will only regrow yet again over time, at which point the problem may be even worse.

This is the least reliable way to treat an aneurysm, and there is little data on long-term follow-up after wrapping.

The aneurysm is essentially left unsecured with the potential for future bleeding.

In short, there are no good treatment methods currently available for these vexing lesions.

As described in detail above, all current treatment options are a high risk and dangerous.

Because there is nothing better available, surgeons are forced to apply a technology that is not designed to treat properly these lesions in particular.

Clips which depend on a soft, compliant aneurysm wall to close are generally not intended for and are no match for a giant, atheromatous aneurysm or an aneurysm full of coils.

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